(HealthDay News) — COVID-19-associated ischemic strokes are more severe than non-COVID-19 ischemic strokes, with worse functional outcome and increased mortality, according to a study published online in Stroke.

George Ntaios, MD, PhD, from the University of Thessaly in Larissa, Greece, and colleagues pooled data from all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke at 28 sites from 16 countries and examined whether stroke severity and outcomes differed for patients with versus without COVID-19. A total of 174 COVID-19 patients with acute ischemic stroke between Jan. 27, 2020, and May 19, 2020, were propensity score-matched in a 1:1 ratio with non-COVID-19 patients.

The researchers found that the median National Institute of Health Stroke Scale was higher in patients with COVID-19 versus matched patients without COVID-19 (10 vs 6; odds ratio, 1.69 for higher National Institute of Health Stroke Scale score). There were 48 deaths, including 22 and 26 attributable to stroke and COVID-19, respectively. Forty-nine of 96 survivors with information about disability status had severe disability at discharge. In the propensity score-matched population, patients with COVID-19 had a significantly increased risk for severe disability (median modified Rankin Scale, 4 vs 2) and death (adjusted odds ratio, 4.3).

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“The association between COVID-19 and severe stroke highlights the urgent need for studies aiming to uncover the underlying mechanisms and is relevant for prehospital stroke awareness and in-hospital acute stroke pathways during the current and future pandemics,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.


Ntaios G, Michel P, Georgiopoulos G, et al. Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry. Stroke. doi: 10.1161/STROKEAHA.120.031208